Dark567 wrote: As far as preventative care(in the US sense), most countries don't do it as extensively as we do. It has mostly been found to be a waste of money which is why in a lot of countries you don't see things like annual physicals and the testing(and liability) culture we have in the US. In most of the other systems of the world, you only go to the doctor when something is already wrong not for preventative medicine(although there are a few exceptions like Pap smears and colonoscopies that are done every 3 instead of 1 year). The idea of US style preventative medicine majorly reducing payouts is a myth, in fact, it is mostly the opposite and an unneeded expense.

I have no professional experience with medicine, so I guess I wasn't familiar with the definition of 'preventative care,' but I'm an American and I would've assumed that 'preventative care' meant diet and exercise and other lifestyle changes. I think if we had a system that pushed this kind of care from doctors or more effectively covered work with the appropriate experts, payouts absolutely would go down.

I mean seriously, having the highest obesity rate in the developed world isn't really helping us with medical costs, just for one example.

Opus_723 wrote:I mean seriously, having the highest obesity rate in the developed world isn't really helping us with medical costs, just for one example.

Except that obesity is a can of causational worms, with a lot of the factors involved in it being related to factors that are outside the individual patient's choice, for instance genetics, depression, being poor, working multiple jobs, or being a single parent, and/or lacking a good social support group can all contribute to problems with weight. Worse still is that having multiple factors working against you can make it harder to achieve change in any one.

And Medical insurance doesn't cover "care" with regards to many of those factors, like job training or housing assistance. Even mental health coverage is not guaranteed despite it's influence on a lot of other things physical health related.

We're in the traffic-chopper over the XKCD boards where there's been a thread-derailment. A Liquified Godwin spill has evacuated threads in a fourty-post radius of the accident, Lolcats and TVTropes have broken free of their containers. It is believed that the Point has perished.

Opus_723 wrote:I mean seriously, having the highest obesity rate in the developed world isn't really helping us with medical costs, just for one example.

Except that obesity is a can of causational worms, with a lot of the factors involved in it being related to factors that are outside the individual patient's choice, for instance genetics, depression, being poor, working multiple jobs, or being a single parent, and/or lacking a good social support group can all contribute to problems with weight. Worse still is that having multiple factors working against you can make it harder to achieve change in any one.

And Medical insurance doesn't cover "care" with regards to many of those factors, like job training or housing assistance. Even mental health coverage is not guaranteed despite it's influence on a lot of other things physical health related.

I agree with all that. My point was that we should work on covering those things if our goal is to actually prevent people from getting sick, and therefore save money. But in my opinion, just covering people to work regularly with physical therapists and evidence-based diet experts ( what the heck are those called, anyway?) before they get sick would go an awful long way toward solving some of the more extreme problems with U.S. healthcare, even if it doesn't solve the obesity epidemic by itself.

Edit: I really don't want to minimize the amount of time and effort these sorts of lifestyle changes take, especially for lower-income people who simply may not have the time to cook meals, exercise, etc. But some movement in that direction from the healthcare system seems preferable to none.

There was a conversation at the hospital, the other day, whether a door sign saying "dietitian" was wrong, and should it have been "dietician". It turns out both are right. But (to me, as well as the relative concerned) the latter (irregularly formed) version looks more correct than the former.

There was also a less official sign (laminated printout, tacked up on a storage cupboard) that stated, amongst other things, that "sterile bowels" could be found inside. I've yet to enquire, either by asking a member of staff or pestering the almighty Google, whether this is actually a thing you'd find in a hospital supplies cupboard (sterile-packed colostomy tubing?), or was it actually "bowls" they meant? Perhaps someone here knows for sure, although I can probably live without knowing, (Even if my patients can't )

https://www.nytimes.com/2018/01/02/upsh ... rison.htmlNew studies show that the US doesn't use more care than other countries, it just charges more. For example, the US spent similar amounts as peer nations in the 1980s. I think that undercuts the argument that the US is subsidizing other countries r&d. The only silver lining is that all this extra spending generates a lot of innovation.

sardia wrote:New studies show that the US doesn't use more care than other countries, it just charges more. For example, the US spent similar amounts as peer nations in the 1980s. I think that undercuts the argument that the US is subsidizing other countries r&d. The only silver lining is that all this extra spending generates a lot of innovation.

How is it not contradictory to say this generates a lot of innovation while maintaining that it undercuts the argument that the US is subsidizing other countries r&d. We pay more for the products that come from the research than anyone else. Of course that is subsidizing research. There are almost certainly more efficient ways to fund research that don't involve massive marketing budgets though.

idonno wrote:How is it not contradictory to say this generates a lot of innovation while maintaining that it undercuts the argument that the US is subsidizing other countries r&d. We pay more for the products that come from the research than anyone else. Of course that is subsidizing research. There are almost certainly more efficient ways to fund research that don't involve massive marketing budgets though.

The graph shows that the higher spending came first, so how exactly are we subsidizing them?

sardia wrote: The graph shows that the higher spending came first, so how exactly are we subsidizing them?

I think I might not following something about your argument. The higher spending came first with regard to what?

Even if there is some order of occurrences that I am missing, if the spending is generating innovation that can then be used in other countries, it is subsidizing other countries. This is not an uncommon occurrence in markets. Entities that are willing to pay more for items that require R&D subsidies those that will pay less. I don't have any data on it but I suspect a market paying more causing increased R&D is much more common than the other way around because R&D speculating that the market will grow is much more risky.

One thing I find a little surprising about that divergence is that it means single payer systems weren't cheaper than the U.S. system for a pretty good chunk of time. Did something major change and is there any way undo it if it did? Even if you can't close the entire gap, it would be nice to find some less controversial solutions to combat rising cost because I don't think single payer is going to be politically viable any time soon.

idonno wrote:One thing I find a little surprising about that divergence is that it means single payer systems weren't cheaper than the U.S. system for a pretty good chunk of time. Did something major change and is there any way undo it if it did?

Why do you say that? To my unaided eye it looks like the US was over 50% more expensive than the UK* in 1980. Just how much of a difference are you expecting it to make?

(*I think the UK is/was the most single-payer of all the single-payer systems.)

idonno wrote:One thing I find a little surprising about that divergence is that it means single payer systems weren't cheaper than the U.S. system for a pretty good chunk of time. Did something major change and is there any way undo it if it did?

Why do you say that? To my unaided eye it looks like the US was over 50% more expensive than the UK in 1980. Just how much of a difference are you expecting it to make?

Right, and the US healthcare system has got better and better at fleecing people since the 80s. Sounds about right.

elasto wrote:(*I think the UK is/was the most single-payer of all the single-payer systems.)

Indeed I'm pretty sure a lot of those countries don't have single-payer, Germany for one from memory.

EDIT: From Wiki:

Germany has a universal[1] multi-payer health care system paid for by a combination of statutory health insurance (Gesetzliche Krankenversicherung) officially called "sickness funds" (Krankenkassen) and private health insurance (Private Krankenversicherung), colloquially also called "(private) sickness funds".